Proctor, Carla Rae
Proctor, Carla Rae is an individual health care provider with primary practice located at 3676 Parker Blvd , Pueblo CO 81008-2212. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Proctor, Carla Rae can be contacted via phone (719) 553-2204.Contact Information
Primary practice address
3676 Parker Blvd
Pueblo CO 81008-2212
Phone: (719) 553-2204
Fax: (719) 553-2222
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 27054 | Colorado |
Profile Details
| NPI number | 1063472173 |
|---|---|
| LBN Legal business name | Proctor, Carla Rae |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 23rd, 2006 |
| Last updated | Apr 15th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063472173 | NPPES |
| Colorado | MEDICAID | 01270545 |
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